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Centene Faces Proposed Class Action Alleging Inadequate Network

By Heidi Culbertson
October 6, 2021
3 min read

Centene Faces Proposed Class Action Alleging Inadequate Network

Policyholders Allege Centene Breached Promise to Provide Network of Doctors

According to a recent federal court ruling, a proposed class action filed by Ohio residents who bought health insurance on an Obamacare marketplace can proceed on their claims for breach of contract, breach of duty of good faith and fair dealing, and fraud against Centene Corporation. Burg Simpson Eldredge Hersh & Jardine PC represents the potential class.

The residents filed legal action against Centene and their subsidiaries, Centene Management Company, and Buckeye Community Health Plan. The complaint alleges Defendants fail to provide a current and accurate list of in-network healthcare providers, subsequently deny payment for healthcare services that were preauthorized, and force policyholders to pay out-of-pocket for services while awaiting preauthorization or when no in-network providers are available.

Centene moved to dismiss the complaint, but on October 4th, Judge Douglas R. Cole of the United States District Court for the Southern District of Ohio denied the motion.  The residents’ claims can now proceed as they adequately alleged Centene failed to honor the promises contained in the insurance policies.

About Burg Simpson

One of America’s foremost plaintiff trial firms, Burg Simpson Eldredge Hersh & Jardine, has a longstanding and nationwide reputation for fighting relentlessly and successfully for victims of negligence, malfeasance, malpractice, and abuse. Our attorneys have never hesitated to fight for our client’s rights and consistently face and defeat formidable adversaries that include big insurance companies, big banks, and big pharma.  Burg Simpson has secured more than $1 billion in verdicts, settlements, and judgments in practice areas spanning catastrophic personal injury, mass tort and class actions regarding gas explosions, dangerous pharmaceutical drugs and devices, medical malpractice, complex commercial and business litigation, construction defects, and workers’ compensation. The firm’s success has also included more than 200 recoveries in excess of $1 million.

Burg Simpson was founded in 1976 by distinguished American trial lawyer Michael Burg. Mr. Burg is an inductee in the Trial Lawyer Hall of Fame and a recipient of the Clarence Darrow Award. He has also been named to the 2016 RoundTable: America’s 50 Most Influential Trial Lawyers by The Trial Lawyer magazine; Law Week’s “Barrister’s Best” as “Best Civil Litigator”; and one of “America’s 50 Leading Trial Lawyers” by the U.S. Legal 500. Mr. Burg has also been recognized by Best Lawyers in America® and Super Lawyers®. Burg Simpson Eldredge Hersh & Jardine now has more than 75 lawyers and over 90 legal professionals. The firm is based in Colorado and has offices in Arizona, Florida, Nevada, New Mexico, Ohio, California, and Wyoming.

Contact Burg Simpson at 513 852 5600 or 888 895 2080

 

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